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Review
. 2021 Feb;47(Supp. 1):S56-S64.
doi: 10.5152/tud.2020.20475. Epub 2020 Oct 30.

The role of surgery in high risk and advanced prostate cancer: A narrative review

Chloe Sheila Dayan Roy  1 , Ashwin Sachdeva  1 , Gokul Vignesh Kandaswamy  2 , Bhavan Prasad Rai  1
Affiliations
Review

The role of surgery in high risk and advanced prostate cancer: A narrative review

Chloe Sheila Dayan Roy et al. Turk J Urol. 2021 Feb.

Abstract

Patients with high-risk and advanced prostate cancer require safe and efficacious therapies likely to offer a survival advantage while minimizing the treatment-related toxicities. Improvements in the surgical technology, diagnostic modalities, radiological staging, and risk stratification have made surgery for high-risk and advanced prostate cancer a safe and feasible option. In this review, we outline the role of radical prostatectomy in high-risk localized, locally advanced, and metastatic prostate cancer. We overview available data evaluating the use of surgery in the context of a multi-modal approach and highlight ongoing trials in this area. Furthermore, the role of surgery as a non-systemic modality for metastasis-directed therapy (MDT) is also described. Emerging imaging modalities enabling more accurate staging and longer follow-up of clinical trials for prognostic endpoints are anticipated to help identify patient cohorts and treatment strategies, where the use of surgical treatments is likely to provide oncological benefits and acceptable toxicity.

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Conflict of interest statement

Conflict of Interest: The authors have no relevant conflicts of interest to declare. A.S. reports research grants from The Urology Foundation, Prostate Cancer UK, The John Black Charitable Foundation, Rosetrees Trust for Medical Research, and JGW Patterson Foundation, outside the submitted work.

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